House Speaker Paul Ryan is still confident about the plans to repeal the ObamaCare, although the replacement bill called the American Health Care Act hangs by a thread. While Ryan assured that the bill will pass through the Congress, it seems that the Republicans are taking heavy blows. Considering the current House setup, the Democrats need only four votes out of the Republicans side to prevent the bill from moving forward.

To recall, the Congressional Budget Office stressed that Ryan's bill will compromise 14 million coverage. This multitude of Americans will likely lose insurance by next year. Further, the CBO report states that the succeeding two years will result in increased premiums by 15 to 20 percent.

On the contrary, Ryan said that he anticipated the CBO report. However, he accused that CBO overestimated the number of uninsured. Ryan believes that reforms through AHCA will subsequently result in $1.2 trillion spending cut. By not forcing Americans to buy something they don't want (referring to ObamaCare), Ryan said that healthcare will become more accessible as opposed to criticisms that people will not buy insurance at all, Breitbart reported.

Here is another dilemma, some Republican governors have already embraced the ObamaCare Medicaid expansion. Governors are wary that new healthcare legislation would eventually phase out ObamaCare by 2020. Ohio Governor John Kasich said that there should be a clear alternative, otherwise AHCA could be risking the healthcare services in general.

Kasich stressed that there are people who suffer from drug addiction, mental disability and even the poor working class who are accessing ObamaCare. While governors clearly don't have direct legislative clout, pressuring their congressmen could yield results. The Hill said that home states could voice out objections to the bill.

Another factor that could pressure the Republicans are the groups from medical sector who directly opposes AHCA. Hospitals, insurers, and physicians supported the passage of ObamaCare in 2010.